Modern concepts in the treatment of urogenital Chlamydia trachomatis infection during pregnancy

Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Chlamydia infection is one of the most common sexually transmitted infections which is caused by the intracellular microorganism Chlamydia trachomatis. Chlamydia has a tropism to the cylindrical epithelium and is capable of affecting the mucous membrane of the urethra, cervical canal, rectum, oropharynx and conjunctiva of the eyes. In women, chlamydial infection can cause cervicitis, urethritis, pelvic inflammatory diseases, tubal factor infertility. During pregnancy, this infection is a provocative factor for preterm birth, premature rupture of membranes, intrauterine infection of the fetus and low birth weight. The analysis of the studies presented in this review substantiates the need for timely detection and  treatment of chlamydia infection, especially during pregnancy. In this regard, the choice of an effective and safe drug during gestation is an important issue. The review examines the principles of diagnosis and treatment regimens for urogenital chlamydia infection in pregnant women. Data from clinical studies on the effectiveness and safety of azithromycin in the treatment of cervicitis of chlamydial etiology in this category of patients are presented.
The article presents a description of clinical cases on the use of Azithromycin EXPRESS in pregnant women with diagnosed C. trachomatis infection.
Conclusion: Treatment with Azithromycin EXPRESS was accompanied by clinical and microbiological recovery, with no adverse reactions during therapy or complications in the ante- and postnatal period. 

Authors’ contributions: Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D. – development of research design, obtaining data for analysis, review of publications on the topic of the article, processing and analysis of the material, writing the text, editing the article.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patients’ Consent for Publication: The patients provided an informed consent for the publication of their data.
For citation: Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D. Modern concepts in the treatment of urogenital Chlamydia trachomatis infection during pregnancy. 
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 148-154 (in Russian)
https://dx.doi.org/10.18565/aig.2024.64

Keywords

chlamydia infection
Chlamydia trachomatis
Azithromycin EXPRESS
pregnancy

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Received 20.03.2024.

Accepted 01.04.2024

About the Authors

Victor L. Tyutyunnik, Professor, Dr. Med. Sci., Leading Researcher of the Center for Scientific and Clinical Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(903)969-50-41, tioutiounnik@mail.ru, Researcher ID: B-2364-2015, SPIN-code: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Olga I. Mikhailova, PhD, Researcher, 1 Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(926)564-68-13, omikhaylova@gmail.com, https://orcid.org/0000-0001-7569-8704
Natalia E. Kan, Professor, Dr. Med. Sci., Deputy Director of Science, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(926)220-86-55, kan-med@mail.ru, Researcher ID: B-2370-2015,
SPIN-code: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Dzhamilia D. Mirzabekova, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(906)110-51-13, +7(920)984-94-07, Jamilya1705@yandex.ru, https://orcid.org/0000-0002-2391-3334

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